Endoscopically Assisted Gastric Stomal Dilation for Reflux and Vomiting after Gastric Banding

Abstract

Stomal stenosis after gastric banding is one of the troublesome problems that can lead to eventual reoperation. Several publications refer to this complication and to reoperation. The author describes a method of dealing with a stomal stenosis and management of the patient on a short or long term basis by dilatation of the stoma. Stomal stenosis is probably more common with non-rigid gastric bands such as Dacron; the author postulates this is due to contracture of the pseudo-capsule which develops over the band in time. By repeated dilatations, this capsule can be stretched, and thereby the stenosis managed. The passage of regulated dilators, placed over an endoscopically guided wire, facilitates this. The author further hypothesizes that rigid bands do not contract after the inevitable pseudo-capsule formation.